<form id="data_section" method="post" enctype="multipart/form-data" action="HospitalManageServlet">
	<input type="hidden" name="action" id="action_to_update">
	<input type="hidden" name="hospital_code" id="hidden_hospital_code">
	<input type="hidden" name="user_code" id="hidden_user_code" value="<%= session.getAttribute("userID") %>">
	<table>
		<tr>
			<td>Region</td>
			<td>
				<select name="ins_region" id="ins_region"></select>
			</td>
		</tr>
		<tr>
			<td>Province</td>
			<td>
				<select name="ins_province" id="ins_province"></select>
			</td>
		</tr>
		<tr>
			<td>Hospital TH</td>
			<td colspan="2"><input type="text" name="ins_hospital_name_th" id="ins_hospital_name_th" maxlength="50" class="textbox_stl"></td>
		</tr>
		<tr>
			<td>Hospital EN</td>
			<td colspan="2"><input type="text" name="ins_hospital_name_en" id="ins_hospital_name_en" maxlength="50" class="textbox_stl"></td>
		</tr>
		<tr>
			<td>Type</td>
			<td colspan="2">
				<input type="radio" name="ins_type" id="ins_type1" value="Private" checked="checked"><label for="ins_type1"> Private</label> &nbsp;
				<input type="radio" name="ins_type" id="ins_type2" value="Public"><label for="ins_type2"> Public</label>&nbsp;  
			</td>
		</tr>
		<tr>
			<td valign="top">Address</td>
			<td colspan="2"><textarea name="ins_address" id="ins_address" cols="35" rows="3"></textarea></td>
		</tr>
		<tr>
			<td>Tel</td>
			<td colspan="2"><input type="text" name="ins_telephone" id="ins_telephone" maxlength="30" class="textbox_stl"></td>
		</tr>
		<tr>
			<td>Email</td>
			<td colspan="2"><input type="text" name="ins_email" id="ins_email" maxlength="50" class="textbox_stl"></td>
		</tr>
		<tr>
			<td>President</td>
			<td colspan="2"><select name="ins_president" id="ins_president"></select></td>
		</tr>
	</table>
</form>
<div id="output"></div>
